We were wondering ourselves last week when the APC and Clinical Lab code set updates would be realeased. Our curiosity got the better of us so I reached out to a couple contacts at CMS and got information on these elusive January 1 updates. According to CMS they were still waiting on ASP data before they could finalize their APC file for 1/1/2009. The ASP data was released this week so we can expect the release of the APC data soon.

The retirement of a LCD is considered by many to be a blessing rather than a problem because while a LCD is active, claims denials are automatic if the requirements of the LCD are not met. This forces the provider to obtain an advance beneficiary notice (ABN). Further, laboratories must maintain a database of LCD edits and update them when LCDs change or new ones are issued. Many think this all goes away when a LCD is retired. Think again!